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NPI Code Detail

MEDICARE: TATUM ISABELLE GREGSTON

MEDICARE: TATUM ISABELLE GREGSTON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1447136825
Entity Type Code : Individual
Provider Name (Legal Business Name) : TATUM ISABELLE GREGSTON
Provider Business Mailing Address
First Line : 200 HAWKINS DR
Second Line :
City : IOWA CITY
State : IA
Zip : 52242-1009
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 200 HAWKINS DR
Second Line :
City : IOWA CITY
State : IA
Zip : 52242-1009
Country : US
Telephone Number : 319-356-2750
Fax Number : 319-353-6343
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2025
Last Update Date : 05/26/2026

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Directions to “ TATUM ISABELLE GREGSTON ” Practice Location

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